Nursing Elites

1. What finding would lead healthcare providers to suspect Turner syndrome in a child?

• A. Webbed neck
• B. Microcephaly
• C. Gynecomastia
• D. Cognitive delay

Correct answer: A

Rationale: A webbed neck is a classic physical characteristic seen in individuals with Turner syndrome, a genetic condition that results from a missing or partially missing X chromosome in females. This distinctive feature occurs due to excess skin on the neck and is a key clinical clue for healthcare providers. Microcephaly (choice B) refers to a small head size and is not typically associated with Turner syndrome. Gynecomastia (choice C) is the enlargement of breast tissue in males and is not a common finding in Turner syndrome. Cognitive delay (choice D) involves intellectual or developmental delays and is not a specific feature of Turner syndrome.

2. A newborn with an anorectal anomaly had an anoplasty performed. At the 2-week follow-up visit, a series of anal dilations is begun. What should the nurse recommend to the parents to help prevent the infant from becoming constipated?

• A. Use a soy formula if necessary.
• B. Breastfeed if possible.
• C. Avoid administering a suppository nightly.
• D. Do not offer glucose water between feedings.

Correct answer: B

Rationale: Breastfeeding is recommended to help prevent constipation in infants due to the easily digestible nature of breast milk, which often leads to softer stools. Breastfeeding is preferred over formula feeding as it provides optimal nutrition for the infant's digestive system. Choice A, using a soy formula if necessary, may be considered only if there are specific dietary concerns or allergies; however, breast milk is still the preferred option. Choice C, avoiding administering a suppository nightly, is correct as it is not a routine method for preventing constipation in infants and may not be appropriate without medical advice. Choice D, not offering glucose water between feedings, is recommended as it may not address the root cause of constipation and may introduce unnecessary sugar to the infant's diet.

3. A parent asks the nurse what to do for their child who has an earache and fever. What should the nurse suggest?

• A. Applying a warm compress to the affected ear
• B. Giving the child a cold drink
• C. Administering acetaminophen
• D. Taking the child to the emergency department

Correct answer: A

Rationale: Applying a warm compress to the affected ear is a recommended home remedy for earaches as it can help reduce pain and discomfort. The warmth can also help improve circulation and promote drainage if there is fluid buildup. Giving a cold drink (Choice B) is not typically beneficial for earaches and fever. Administering acetaminophen (Choice C) can help reduce fever and alleviate pain, but addressing the earache directly with a warm compress is a more targeted approach. Taking the child to the emergency department (Choice D) is not necessary for a common earache unless there are severe symptoms or complications present.

4. A nurse is teaching the parents of a child with a diagnosis of type 1 diabetes mellitus about insulin administration. What should the nurse emphasize?

• A. Rotate injection sites
• B. Administer insulin before meals
• C. Store insulin in the refrigerator
• D. Administer insulin at bedtime

Correct answer: A

Rationale: The correct answer is to rotate injection sites. Rotating injection sites is crucial in insulin administration to prevent lipodystrophy, which is the breakdown of subcutaneous fat at the injection site. It also helps ensure consistent insulin absorption. Administering insulin before meals (choice B) is important to match insulin peak action with the rise in blood glucose after eating. Storing insulin in the refrigerator (choice C) is correct to maintain its potency and stability. Administering insulin at bedtime (choice D) may not be suitable for all patients and is not a universal recommendation for insulin administration.

5. When caring for a child diagnosed with bronchiolitis, what is the priority nursing intervention?

• A. Administering bronchodilators
• B. Providing respiratory therapy
• C. Monitoring oxygen saturation
• D. Encouraging fluid intake

Correct answer: B

Rationale: The priority nursing intervention for a child with bronchiolitis is providing respiratory therapy. This intervention aims to maintain airway patency, optimize oxygenation, and support effective breathing. Administering bronchodilators, though important, may not be the initial priority as respiratory therapy takes precedence in ensuring adequate oxygenation and ventilation. Monitoring oxygen saturation is crucial but is usually part of the ongoing assessment following the initiation of respiratory therapy. Encouraging fluid intake is essential for hydration but is not the priority intervention when addressing the respiratory distress associated with bronchiolitis.

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